Social Security Disability (SSD) gives disabled Jacksonville residents a lifeline when they cannot return to work full time. However, obtaining approval for Social Security benefits can be a challenge. The Social Security Administration (SSA) may deny SSDI claims, but applicants have the option to appeal a decision.
If you are considering applying for SSD or have applied and received a notification of denial, a Social Security Disability lawyer can help. We assist clients with both their initial SSD applications and with the appeals process if the SSA denies the initial request.
Social Security Administration Disability Standards
The SSA defines disability as lacking the ability to engage in gainful work due to a medically determinable (provable) physical or mental impairment.
To qualify for disability, you must submit a comprehensive claim that proves your disability qualifies under the SSA standards. Your disability must either be severe or life-threatening enough to preclude you from working for 12 months or more.
The Disability Evaluation under Social Security lists the general categories of impairments that qualify for benefits:
- Musculoskeletal system
- Special senses and speech
- Respiratory disorders
- Cardiovascular system
- Digestive system
- Genitourinary disorders
- Hematological disorders
- Skin disorders
- Endocrine disorders
- Congenital disorders
- Neurological disorders
- Mental disorders
- Immune system disorders
In addition to considering the condition responsible for your disability, the SSA will also take into account your age, experience, education, and other related factors.
Applying for Social Security Disability
The process and requirements for applying for Social Security Disability depend on whether you need Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Social Security Disability Insurance (SSDI)
SSDI pays disability benefits to disabled workers, disabled widows, divorced spouses, and disabled adult children. You pay into the SSDI fund every week you work through payroll taxes (FICA), earning credits toward eligibility. Once you accumulate the minimum number of credits, you are eligible to collect this benefit if you become disabled.
Supplemental Security Income (SSI)
The SSI program is for individuals who did not accumulate sufficient credits to earn SSDI eligibility and who have few or no assets. To receive this benefit, you must be at least 65 or meet the SSA standards for disability.
Your claim must comply with the required format, and it must provide specific and complete proof of your disability. Supporting statements from your doctor must illustrate that you have the condition in question, as well as how the condition prevents you from working.
This report, known as the residual functional capacity (RFC) assessment, must meet specific and exacting standards. For the SSA to approve your claim, the doctor performing the RFC assessment must meet the SSA’s required qualifications.
After evaluating your claim, the SSA may request that you see a doctor of their choosing for a compulsory medical examination, known as a CME. Consider consulting a law firm before attending a CME exam since the exam can lead to a denial of your claim.
How a Social Security Disability Lawyer Can Help
Having a Social Security Disability lawyer can help you avoid the pitfalls that will likely lead to a denial of your claim. The Law Offices of Anidjar & Levine can put our knowledge and experience to work for you, handling every aspect of your application to improve your chances of approval.
We will start by gathering your medical records and documentation to substantiate your claim. Some of the medical records we will assemble include:
- Medical test results
- Imaging scans
- Lab reports
- Medical treatment and surgery reports
- Medication history
- Proposed treatment plans
We may refer you to a doctor who is best suited to evaluate your condition and perform your assessment. If your doctor provides this documentation, we will provide the necessary forms, format, and guidance.
Reasons for a Denial of Benefits
The SSA routinely denies claims because they are incomplete, the documentation does not support your claim, or your doctor is unqualified. Along with these reasons, other issues can lead to a denial of benefits.
Failing to Follow Your Medical Plan
If you were prescribed rehabilitative therapy after an injury but failed to follow through with it, the SSA may deny your claim. This is why it is important to prioritize seeking medical attention and follow through with your treatment plan.
Your Income Exceeds the Required Limit
If you earn over a certain amount of money, the SSA will deny your claim for benefits. The required limit changes every year. Additionally, your benefits will be reduced if you earn more than a certain amount of money each month.
Your Disability is Not Severe or Lasts Long Enough
To receive benefits, the SSA requires a disability to keep you out of work for at least 12 months, with few exceptions. If medical documentation cannot show that your injuries are severe enough, you will have a difficult time collecting SSDI benefits. Since every injury and recovery period is unique, each case is evaluated individually. We can help prepare your initial claim so that it abides by the SSA requirements.
Appealing a Denial of Social Security Disability Benefits
Appealing a denial of SSDI benefits is a complex process with multiple steps. We can guide you through each of these steps and keep you informed about your appeal along the way.
Request for Reconsideration
If you do receive a denial, we must get to work on an appeal immediately because the SSA only allows 60 days to file a Request for Reconsideration. During reconsideration, someone who did not handle your original claim will conduct a complete review of the evidence originally submitted, along with any new information.
We will determine our strategy for an appeal based on the reason for the SSA’s denial and submit the Request for Reconsideration along with any additional materials necessary. We may reach out to your doctors to provide additional documentation of your medical condition to support your request.
Hearing Before an Administrative Law Judge
If the SSA denies your Request for Reconsideration, we will proceed to the next level of appeal and request a hearing before an administrative law judge. These requests can be made online, and you can choose to present your argument in person or via video. If you choose to conduct a hearing in person, we can arrange for you to do so at a local hearing office.
The Appeals Council
If the administrative law judge upholds the original decision of your denial of benefits, we will appeal your case to the Appeals Council, which will review the judge’s decision. The Appeals Council may deny your request if it determines that the administrative law judge’s decision upholds the SSA’s laws and regulations.
Otherwise, the Appeals Council will make its own decision on your case or return it to the administrative law judge for further review.
If the Appeals Council denies your claim, we can file an appeal in Federal Court.
Whatever steps may be necessary to pursue your Social Security Disability award, our legal team will work diligently and exhaust every possible option available to obtain the results you deserve.
Contact the Law Offices of Anidjar & Levine
Trying to navigate the SSA disability claim process alone can be confusing and exhausting. Our personal injury lawyers understand this complicated process and how to structure your claim to meet the SSA’s requirements.
Remember that denial does not necessarily reflect on the validity of your claim. We offer a complimentary case evaluation to help determine the best course of action for you. Contact the Law Offices of Anidjar & Levine today for your free consultation to see how a social security disability lawyer can help.